Kornimate/medical-research-clean huggingface dataset:
syphilis and hiv point of care testing (poct) in saskatchewan

Conditions: Syphilis; HIV Infections

Summary: the goal of this clinical trial is to learn about syphilis and hiv point of care testing among inner city, remote, rural and hard to reach populations in saskatchewan. the main question\[s\] it aims to answer are: 1. to evaluate the field diagnostic test performance (e.g. sensitivity, specificity, predictive values) of finger prick whole blood point of care testing (poct) when compared to standard serum based testing for syphilis poct, hiv poct and dual syphilis and hiv poct. 2. to evaluate the clinical utility of poct for the prompt management and public health follow up of syphilis and hiv cases as compared to usual testing, specifically: 1. time to diagnosis 2. time to treatment 3. number of contacts exposed to untreated infections 4. for hiv diagnoses, time to connection to clinical provider for ongoing management of hiv 3. to evaluate the acceptability and feasibility of poct among different populations for syphilis and hiv among at risk and/or hard to reach populations, specifically: 1. health care provider experiences of feasibility and acceptability of the poct used in this pilot 2. client acceptability and experiences with poct in this pilot 3. client preferences for test offered (syphilis only, hiv only, or dual test of hiv and syphilis 4. to evaluate the acceptability and feasibility of syphilis alone, hiv alone or combined syphilis/hiv poct among at-risk and/or hard to reach populations. participants will be assessed for risk factors that may increase risk of infectious disease such as substance use and sexual habits. they will then be offered a choice of 1 of 3 poct(syphilis alone, hiv alone or a dual hiv/syphilis test). serology will be obtained for sexually transmitted and blood born infections (stbbi's) and then the point of care test (poct) will be completed. following the testing the participant will complete a short survey on their experience.


Eligibility criteria:
inclusion criteria: * 1650 consecutive individuals * \> 16 years accessing stbbi testing at specific locations and able to provide informed consent. plwh and persons who are syphilis positive may also eligible to participate. exclusion criteria: ° less than 16 years, unable to provide signed informed consent (e.g., intoxicated)

Keywords: point of care testing
machine learning model guided by tls predicts survival and immune features in gastric cancer

Conditions: Locally Advanced Gastric Cancer; Tumor Immune Microenvironment; Tertiary Lymphoid Structures (TLS)

Summary: this study aims to develop and validate a machine learning model that uses information from tertiary lymphoid structures (tlss)-specialized immune-related cell clusters found near tumors-to predict survival outcomes and immune characteristics in patients with locally advanced gastric cancer. by analyzing clinical data, pathology, and imaging results, the model may help doctors better understand a patient's prognosis and personalize treatment strategies. the study will also explore how tls-related immune patterns relate to the effectiveness of certain therapies, potentially offering new insights for immune-based treatment planning.


Eligibility criteria:
inclusion criteria: histologically confirmed locally advanced gastric adenocarcinoma (clinical stage ct2-t4 and/or n+) underwent curative-intent gastrectomy (with or without neoadjuvant therapy) availability of adequate tumor tissue specimens for tls assessment via digital pathology complete baseline clinical, pathological, and follow-up data age ≥ 18 years written informed consent provided (if prospective study component is included) exclusion criteria: distant metastases at the time of diagnosis or surgery (m1 stage) prior history of other malignancies within the past 5 years, except for adequately treated in situ carcinoma or non-melanoma skin cancer incomplete or missing essential clinical, pathological, or survival data poor-quality tissue samples not suitable for tls quantification or digital analysis participation in another clinical trial that may interfere with the study outcomes
comparing two-time points of thyroid hormone replacement during the holy month of ramadan

Conditions: Hypothyroidism

Summary: muslims all over the world fast during the month of ramadan from dawn until dusk. there is little data regarding the best timing of levothyroxine intake during the month of ramadan where taking it on an empty stomach represents a challenge to most patients.this study aims to compare two-time points of levothyroxine intake during ramadan in terms of change in thyroid stimulating hormone (tsh), compliance and convenience.

hypothyroidism requires regular replacement with levothyroxine to achieve euthyroidism (thyroid hormone status within the normal range). usually, levothyroxine is taken orally in the morning on a daily basis. in clinical practice, the investigators have observed that this levothyroxine replacement is sub-optimal resulting in higher levels of thyroid stimulating hormone. based on this observation, the investigators conducted this study to examine whether timing of oral intake of levothyroxine during the holy month of ramadan will affect achievement of euthyroidism. they recruited 96 hypothyroid patients taking levothyroxine, attending hamad endocrine outpatient clinics, who were fasting during ramadan( may-june 2017)and for whom there is no clinical contraindication to fasting. patients were randomly assigned to two time points for taking levothyroxine: a. 30 minutes before the iftar meal b. 30 minutes before suhour the primary outcome was the change in thyroid stimulating hormone (tsh) before and after ramadan. the null hypothesis is that there is no difference in tsh between the two groups. the findings from the study will help in the clinical care of patients with hypothyroidism in ramadan. hypothyroidism is common worldwide and many muslims will require the appropriate advice regarding management of hypothyroidism in ramadan.

Eligibility criteria:
inclusion criteria: * patients with primary hypothyroidism who had stable tsh over the last 6 months prior to the study period * age between 18-70 years old * patients who planned to fast during ramadan. exclusion criteria: * patients with any end organ damage * pregnant ladies * patients with thyroid cancer * patients not adhering to medications * patients who had a clinical contraindication to observe fasting.

Keywords: fasting
mechanisms of prediabetic states in sleep apnea

Conditions: Sleep Apnea; Pre-diabetes

Summary: the purpose of this study is to better understand how sleep apnea contributes to the development of diabetes.

substantial evidence indicates that obstructive sleep apnea (osa) is associated with impaired glucose metabolism, however, metabolic mechanisms underlying this association remain unclear. this mechanistic study will determine systemic and cellular metabolic pathways that contribute to impaired glucose metabolism in obstructive sleep apnea (osa). understanding of how obstructive sleep apnea (osa) affects glucose metabolism may help identify novel targets for risk prediction and/or treatment of metabolic impairments beyond continuous positive airway pressure (cpap). obstructive sleep apnea (osa) patients with prediabetes will be studied under three in-laboratory conditions in a randomized cross-over design: untreated condition (obstructive sleep apnea), treated condition (continuous positive airway pressure), untreated but pharmacologically suppressed lipolysis condition (niacin). the investigator will perform whole body and cellular assessments under each study condition.

Eligibility criteria:
inclusion criteria: * overweight or obese * prediabetic * sleep apnea exclusion criteria: * diabetic * severe hypertension * taking medications that can confound assessments * any history of known bleeding disorders * any underlying disease likely to limit life span or increase risk of intervention * currently pregnant, trying to get pregnant or nursing

Keywords: sleep
evolution of sexual life quality of women with poi before and after introduction of hormone replacement therapy

Conditions: Premature Ovarian Failure

Summary: the aim of this study is to evaluate the evolution of quality of sex life of women with poi after introduction hormone replacement therapy through the fsfi scale

premature ovarian failure (poi) is a pathology that affects about 1-2% of women before the age of 40. the resulting estrogen deficiency is the cause of multiple repercussions. clinically, sexual disorders may appear in the short term, such as a decrease in libido, vaginal dryness, an increase in dyspareunia, resulting in less frequent sexual intercourse and less satisfaction with sexual life. the quality of life of these patients also appears to be reduced compared to women with normal ovarian reserve. a 2008 study showed that the sexual function of patients with poi treated with hormone replacement therapy (hrt) was normal but remained significantly lower than that of patients with normal ovarian function. however, no study has attempted to assess the evolution of the symptomatology of these patients before and after the introduction of hrt. evidence of improvement in sexual disorders under treatment could be an additional argument to improve patient adherence and treatment compliance; as well as information for health professionals

Eligibility criteria:
inclusion criteria: * positive diagnosis of poi (amenorrhea \> 4 months or spaniomenorrhea \> 4 months and fsh \> 25 iu/l checked twice, more than 4 weeks apart) * absence of hormonal treatment, * patient's oral consent, * affiliated or beneficiary of health insurance exclusion criteria: * contraindication to hormonal treatment (history of hormone-dependent cancer, history of ischemic arterial stroke), * inability of the patient to understand the nature or risks or significance and implications of the clinical investigation, * patient under legal protection

Keywords: premature ovarian insufficiency sexuality quality of life
investigation of the effect of manual therapy and pelvic floor exercises on pelvic floor muscles

Conditions: Colonic Inertia; Dyschezia; Constipation

Summary: the goal of this clinical trial is to investigation of the effect of manual therapy and pelvic floor exercises on pelvic floor muscle in women with constipation. the main question\[s\] it aims to answer are: * in addition to pelvic floor exercises, manual therapy applied to the pelvic floor muscles has no impact on constipation. * in addition to pelvic floor exercises, manual therapy applied to the pelvic floor muscles has an impact on constipation. participants will apply pelvic floor exercises and manual therapy techniques. if there is a comparison group: researchers will compare \[insert groups\] to see if \[insert effects\].

* female participants aged 18-55 years with constipation complaints will be recruited through social media and hospital outpatient clinics, and those who volunteer to participate will be enrolled in the study. * participants will be assessed as group 1 (pelvic floor exercises), group 2 (pelvic floor exercises + manual therapy techniques). group 1 will receive diaphragmatic breathing training and then pelvic floor exercises to strengthen the pelvic floor. * group 2 will receive manual therapy methods consisting of momentum minus mobilisation, sphincter opening, colon massage, global fascial manipulation, trigger point and myofascial release in addition to diaphragmatic breathing training and pelvic floor exercises. * participants will receive exercise training 5 days a week for 6 weeks. manual therapy methods will be used 2 days a week for the first 2 weeks and then 1 day a week. initial assessment of participants and manual therapy applications will be done face to face. the exercises will be continued using the online telerehabilitation method. * both groups will be given nutritional advice, such as drinking plenty of water, eating fibre-rich foods and preferring foods that aid digestion. participants will be advised to take their time every day, in the morning, at the same time, without rushing to defecate, preferring an squat toilet, which increases intra-abdominal pressure, half an hour after meals, but not for more than five minutes.if a european toilet is used, toilet training will be given about leaving a 15-18 cm long ridge under the feet. * both groups will be given assessment tests before and at the end of the trial and the results will be compared.

Eligibility criteria:
inclusion criteria: * constipation in the last 6 months * being able to use smartphones and social media (whatsapp and instagram) * not having a health problem that prevents exercise * able to communicate * literate exclusion criteria: * not had constipation in the last 6 months * pregnancy or recent pregnancy * had surgery * having a tumour * having vertigo taking medication (use of bowel-regulating drugs) * previous physiotherapy for constipation problems * inflammatory bowel disease

Keywords: constipation pelvic floor manual therapy exercise
analgesic benefits of genicular nerve blocks of the posterior knee for patients undergoing acl reconstruction

Conditions: Rupture of Anterior Cruciate Ligament

Summary: outpatients scheduled to have acl surgery typically receive a femoral nerve block to provide analgesia for the front of the knee. postoperatively, these patients will often report pain in the back of the knee. local anesthetic infiltration of the posterior aspect of the knee results in blockade of the genicular nerves of the posterior knee. these nerves originate off of the tibial and common peroneal nerves and their blockade will result in improved posterior knee pain relief and may decrease narcotic consumption compared to patients who receive the same infiltration with normal saline.

femoral nerve blocks are commonly used to provide postoperative analgesia for acl surgery. the limitation of these blocks is the incomplete analgesia they provide of the knee joint subjecting the patient to posterior knee pain. as a result, some of these patients receive rescue sciatic blocks in the postoperative care unit to cover posterior knee pain. the sciatic block provides excellent analgesia for the posterior knee; however its blockade invariably affects other territories of the sciatic nerve such as the lower leg and foot. for acl surgery, the loss of sensation and/or motor strength to this area is unnecessary and may make ambulation more difficult. the ability to ambulate with minimal assistance may be more important for a patient undergoing an outpatient surgery when compared to an inpatient surgery. at the posterior knee, the sciatic nerve branches off into the tibial and common peroneal nerves which give rise to sensory fibers that innervate the posterior knee. we propose targeting these terminal fibers in the popliteal fossa by infiltrating local anesthetic between the distal femoral shaft and popliteal artery thereby providing posterior knee analgesia without affecting the lower leg.this application of this block has not been studied in patients having acl surgery. a single interim analysis is scheduled after the data for 50 cases are available.

Eligibility criteria:
inclusion criteria: 1. patients who are presenting for acl reconstruction 2. candidates for peripheral nerve blocks patients 3. asa 1-3 exclusion criteria: 1. patient refusal 2. asa classification of 4 or higher 3. pre-existing neuropathy in the femoral or sciatic distribution 4. coagulopathy 5. infection at the site 6. non-english speaking or non-reading patients 7. chronic opioid use (\>3months) 8. pregnancy 9. any other contra-indication to regional anesthesia 10. failed femoral nerve block 11. sciatic nerve block placed due to severe pain not managed by intravenous and oral agents.

Keywords: anterior cruciate ligament reconstruction
rsa study on the behaviour of the growth plate during and after temporary hemi-epiphysiodesis and epiphysiodesis

Conditions: Anisomelia; Deformity of Limb

Summary: by using radiostereometric analysis (rsa) we will be able to study growth during and after temporary epiphysiodesis and with great accuracy be able to detect asymmetric growth following this procedure. by using the same method we also want to analyse patients with axial deviations operated with guided growth (tension band plating) to study the growth during and after the procedure and be able to set the correct timing for removal of the implant.

the rsa method consists of implantation of small tantalum beads on either side of the physis during surgery on the the physis. later analysis of the rsa pictures with the rsa-method will give us an microscopically accurate measure of the growth in three planes.

Eligibility criteria:
inclusion criteria: * children with idiopathic axial deviations in the lower extremities * children with limb length discrepancys where timing of epiphysiodesis is difficult because of a big discrepancy in skeletal age and chronological age exclusion criteria: * children with axial deviations and pathological physis

Keywords: lld, guided growth
pediatric disease registry in essential thrombocythaemia (et)

Conditions: Essential Thrombocythemia (ET)

Summary: the aim of this study is to evaluate the progression of et in children (aged 6-17years inclusive) over a period of 5 years maximum. the study will also assess how children are diagnosed, treatment options for those children with symptoms and events related to their et and the outcomes of those treatments.


Eligibility criteria:
inclusion criteria: - 6 years or over and less than 18 years patient has et according to the who criteria as guidance exclusion criteria: * interventional clinical study participation
progressive familial intrahepatic cholestasis in indian children - establishing an indian pfic registry

Conditions: Progressive Familial Intrahepatic Cholestasis

Summary: the project will amalgamate data from several large indian centers to describe the genotype, clinical spectrum, natural course, genotype-phenotype correlation, outcome, and response to medical therapy in indian children with progressive familial intrahepatic cholestasis (pfic). this will be the first such indian registry of children with pfic. there are currently limited single-center studies describing the genotype, natural course, and outcome of indian children with pfic. data will be collected retrospectively from the participating centers across the country. only genetically confirmed cases would be included.

there is a lack of robust literature from india on pfic. the study would be the first to extensively describe the genotype of indian children with pfic and their natural course. being a multicentric study, the results generated would therefore be applicable to the whole of the country. understanding the prevalent genotypes in the indian population and their related phenotype would help both the individual management decisions of these patients and further policy-making for their diagnosis and treatment. with the advent of genetic diagnosis through sequencing techniques and these tests becoming more affordable, every indian center is now diagnosing a fair number of these cases which used to go undiagnosed previously. this has changed the landscape of cholestatic liver disease in children where pfics are now the most prevalent pediatric cholestatic disorder. european studies have demonstrated 2 common mutations where patients respond very well to surgical biliary diversion and have good native liver survival. these mutations have rarely been reported in india. results from this study could thus guide appropriate decision-making based on outcome and help choose the modality of treatment for the individual patient - medical, surgical biliary diversion, or liver transplantation.

Eligibility criteria:
inclusion criteria: * genetically proven homozygous or compound heterozygous mutations of atp8b1/ abcb11/ abcb4/ tjp2/ nr1h4/ myo5b/ usp53/ kif12 and * clinical and biochemical evidence of chronic cholestatic disease and / or * histological features of intrahepatic cholestasis with suggestive immunohistochemistry exclusion criteria: * genetic analysis showing mutations unrelated to intrahepatic cholestasis according to database * clinical, biochemical, and histological evidence of progressive familial intrahepatic cholestasis without a genetic sequencing report
effects of 12- weeks of quantitative weight-bearing progressive resistance exercise training on glycemia control and improving muscle strength with type 2 diabetes combine pre-sarcopenia.

Conditions: Twelve Week Quantitative Weight Bearing of Resistance Training Effect on Glycemic Control and Muscle Strength

Summary: according to the international diabetes federation (idf) in 2017 investigator found that the incidence of type 2 diabetes is currently 425 million people aged 20 to 79 in the world, and this data will increase o 629 million at 2045, the etiology of more than 90% is related to aging, it has become a serious challenge to public health. sarcopenia is a newly noticed severe syndrome characterized by reduced walking speed, decreased grip strength, and decreased muscle mass. patients with type 2 diabetes are at risk of sarcopenia and are those with normal blood sugar. one of the main ways to improve the face of sarcopenia is to exercise intensity. by carrying out a gradual training plan instead of using different weights, it will lead to muscle hypertrophy and increase in muscle strength to achieve muscle gain. in view of the fact that the commercially available sandbags are cheap and easy to obtain, the weight is fixed, and the use variability is high, it is expected to introduce quantitative weight-bearing progressive exercises in type 2 diabetes and have symptoms of muscle loss to improve muscle mass, and to control blood sugar. the quality of life can have better benefits.

purpose:this study aim is effectiveness of 12 weeks quantitative weight-bearing progressive exercise training in patients with type 2 diabetes mellitus(t2dm) with pre-sarcopenia promotion muscle strength and blood sugar control. hypothesis:after 12 weeks of quantitative sandbag training , the experimental group can have a significant increase in the muscle mass of the upper and lower limbs、grip strength、5-time chair stand test、lipid profile、glycemic control(hba1c) and quality of life. methods:this study will be a randomized controlled trial. forty adult diagnosis with t2dm with pre-sarcopenia patient randomly assigned to experimental group and control group. experimental group wearing 0.5 kg quantitative sandbag 12\~15 repetitions/set x 5 set x 3day. weight adjustment: after the first month of intervention, if the experimental can perform for more than 20 repetitions/set , we will asked to increase the weight of the sandbag to 1 kg until the end of the experiment conditions:the effectiveness of 12 weeks quantitative weight-bearing can improvement of glycemic control and limb muscle strength.

Eligibility criteria:
inclusion criteria: * age between 50 \~80 years * t2dm * physician and check calf circumference (m: \<34 cm, f: \<33 cm)、handgrip strength (m: \<28 kg, f: \<18 kg) exclusion criteria: * inability to perform any self -activity * dm with lower limb neuropathy, r * dm with retinopathy * stroke * foot opening wound * past history even doing limb resistance training; * easy fall down high risk patients

Keywords: resistance training；muscle strength；glycemic control